We have experienced a case of occult hepatocellular carcinoma metastasized to the heart in a 41 year old female. The hepatocellular carcinoma invaded the hepatic vein, grew in a snakelike fashion up the inferior vena cava and reached the right atrium. Ultrastural examination in this case confirmed the hepatocellular origin of the tumor.
Female ; Humans ; Carcinoma, Hepatocellular

BACKGROUND: Overstimation of blood pressure(BP) by clinic measurements occur in about 20 to 30% of subjects(white-coat hypertension) who may, consequently, be misdiagnosed as hypertensives and received unnecessary medications. The clinical significance of white-coat hypertension and its effects on the cardiovascular wystem have not been studied systematically.This study was designed to evaluate the influences of white-coat hypertension and white-coat effect, defined as difference between clinic and ambulatory BP, on the LV mass and diastolic function. METHODS: LV mass index was calculated and LV systolic and diastolic function were assessed by the analysis of mitral and pulmonary venous flow velocity in 45 untreated essential hypertensives and 20 normotensives(NT). Ambulatory BP monitoring classified hypertensives as white-coat hypertensives(WCHT,n=20) and sustained hypertensives(SHT, n=25). RESULTS: 1) Left ventricular systolic indices were not different among the three groups. 2) Left ventricular mass inedx of WCHT(114.5+/-36.3g/m2) was similar to that of SHT(115.6+/-34.9g/m2) and was significantly greater than that of NT(86.5+/-37.7g/m2)(p<0.05). 3) Some of left ventricular diastolic parameters(isovolumic relaxation time, E/A ratio, A velocity, pulmonary systolic fraction, ratio of systolic to diastolic forward flow velocity) of WCHT and SHT were significantly different from those of NT(p<0.05), but there were no differences between two hypertensive groups. 4) Even though both systolic and diastolic white-coat effect in WCHT were significantly greater than those of SHT(o<0.05),white-coat effect did not influence on the left ventricular mass or function in both groups. CONCLUSION: An increased left ventricular mass and diastolic dysfunction in WCHT suggests that white-coat hypertension could not be considered as an entirely innocuous clinical condition.
Blood Pressure Monitoring, Ambulatory ; Hypertension* ; Relaxation

During the last decade, with the advent of prenatal ultrasound, multicystic dysplastic kidney is diagnosed with increasing frequency But the management of multicystic dysplastic kidney continues to be an ongoing controversy regarding both its cause and its current management. Herein we reviewed the records of four cases at our hospital between 1983-1993. All were unilateral and three cases were removed surgically and last one was observed and followed up only. The first case was a ten-month-old girl who was referred to our department because of hydronephrosis of kidney. The second was a five-year-old boy with chief complaints of flank pain. The third was a three-month-old girl, and the fourth was a two-day-old girl. Last two cases were referred to our department because of a sustained cystic dilatation of kidney detected by prenatal ultrasonography.
Dilatation ; Female ; Flank Pain ; Humans ; Hydronephrosis ; Kidney ; Male ; Multicystic Dysplastic Kidney* ; Ultrasonography ; Ultrasonography, Prenatal

No abstract available.
Neck* ; Posture* ; Rabbits*

The clinical courses of four male patients who have concurrently discovered transitional cell carcinoma of the bladder and adenocarcinoma of the prostate were presented, each meets to Warren and Gate`s criteria. In the management of bladder cancer, 2 patients were treated by radical cystoprostatectomy with urinary diversion and remaining 2 by more conservative modalities such as transurethral resection of the bladder tumor. In the management of prostatic cancer, 3 patients were treated by hormonal therapy including bilateral orchiectomy and remaining1 by radiation therapy with bilateral orchiectomy. The modalities for management plan of all cases had decided by the stage and grade of transitional cell carcinoma of the bladder rather than adenocarcinoma of the prostate.
Adenocarcinoma ; Carcinoma, Transitional Cell ; Humans ; Male ; Orchiectomy ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion

The clinical courses of four male patients who have concurrently discovered transitional cell carcinoma of the bladder and adenocarcinoma of the prostate were presented, each meets to Warren and Gate`s criteria. In the management of bladder cancer, 2 patients were treated by radical cystoprostatectomy with urinary diversion and remaining 2 by more conservative modalities such as transurethral resection of the bladder tumor. In the management of prostatic cancer, 3 patients were treated by hormonal therapy including bilateral orchiectomy and remaining1 by radiation therapy with bilateral orchiectomy. The modalities for management plan of all cases had decided by the stage and grade of transitional cell carcinoma of the bladder rather than adenocarcinoma of the prostate.
Adenocarcinoma ; Carcinoma, Transitional Cell ; Humans ; Male ; Orchiectomy ; Prostate* ; Prostatic Neoplasms ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Diversion

Gastritis cystica profunda is a rare condition in which mature glandular epithelium extends ino the tissues beneath the muscularis mucosae. It is analogous to similar conditions affecting the small and large intestines that are called, enteritis and colitis cystica profunda. Macroscopically, gastritis cystica profunda may present not only as a submucosal tumor or as solitary or diffuse polyps, but also as a giant gastric mucosal fold rarely These lesion have been found not only at the site of a gaatroenterostony but also in the stomach of patients without previous surgery. We present herein a patient having gastritis cystica profunda without any previous surgery, in which it present as a giant gastric mucosal fold.
Colitis ; Enteritis ; Epithelium ; Gastritis* ; Humans ; Intestines ; Mucous Membrane ; Polyps ; Stomach

A clinicostatistical analysis of 683 males with infertility who visited the Pusan National University Hospital between January 1986 and December 1995 was performed. We divided the patients into 5 groups by Shirataki classification as follows, group I, sperm concentration above 20 x 106/ml, group II, oligozoospermia with a sperm concentration above 10 x 100000/ml, but below 20 x 1000000/ml, group III,oligozoospermia with a sperm concentration below 10x 100000/ml, group IV, primary azoospermia, group V, obstructive azoospermia. The mean age was 33.1 years. The mean duration of infertility was 48.2 months. The frequency in each groups were group IV 383 cases (56.1%), group III 127 cases (18.6%), group I 111 cases (16.3%), group II 37 cases (5.4%), and group V 25 cases (3.7%), respectively. Except group V, as decreasing the sperm density, testicular volume tended to reduce (p<0.01). The semen volume in group V was significantly less than that in other groups (p<0.05). As sperm density decreased, the sperm motility tended to reduce (p<0.05). The levels of serum luteinizing hormone (LH) and follicular stimulating hormone (FSH) in group IV were significantly the higher than other groups (p<0.05). As for serum prolactin and testosterone, there were no significant differences between each 5 group. Of etiologic factors of male infertility, idiopathic was the most common cause with 489 cases (71. 6%), and followed by varicocele 71 cases (10.4%), seminal tract obstruction 44 cases (6.4%), chromosome abnormality 30 cases (4.4%), infection 20 cases (2.9%), testicular trauma 13 cases (1.9%), cryptorchidism 10 cases (1.5%), hyperprolactinemia 4 cases (0.6%) and retrograde ejaculation 2 cases (0.3%). A total of 391 cases had a management for male infertility which consisted of medical treatments 291 cases (74.4%), surgical treatments 89 cases (22.8%) and assisted reproductive technologies 11 cases (2.8%). In conclusion, We think the more clear clarification of physiology of male reproductive system, the development of new drugs for the improvement of spermatogenesis and the application of advanced assisted reproductive technique would be needed to handle properly the patients with male infertility.
Azoospermia ; Busan ; Chromosome Aberrations ; Classification ; Cryptorchidism ; Ejaculation ; Humans ; Hyperprolactinemia ; Infertility ; Infertility, Male* ; Luteinizing Hormone ; Male ; Male* ; Oligospermia ; Physiology ; Prolactin ; Reproductive Techniques, Assisted ; Semen ; Sperm Motility ; Spermatogenesis ; Spermatozoa ; Testosterone ; Varicocele

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in Korea. The overall rate of MRSA in hospitals in Korea was estimated over 60%. Recently hospital infections caused by MRSA are getting increased and problematic in Korea, Our hospital Seoul Paik Hospital, has been trying to solve this problem. We had not applied exact methods for hospital infection control. Therefore, we adapted strict methods under the control of hospital infection control committee (HICC) and assessed the effectiveness of these methods. METHODS: Every month, the number of MRSA isolates was collected and analyzed; the results of the analysis were reported to every ward. All wards were supplied with Microshild(R) (Johnson & Johnson, Australia), Clean N' Fresh(R) (Carroll, USA), and standard paper towels. Health care workers were regularly educated for hospital infection control. The use of antibiotics was controlled by the HICC. We compared MRSA isolation rate between before and after applying the strict infection control methods under the regulation of HICC. Mann-Whitney U test, one-way ANOVA, and Chi-square test were used for statistical analysis of the results. RESULTS: After restricting the uses of antibiotics, glycopeptides and carbapenems were prescribed 15% less (20.3 vs 17.3 DDD /1000 patient-days) and 35% less (9.3 vs 6.0 DDD /1000 patient-days) respectively, compared to before restricting antibiotics. Methicillin resistance rate was decreased from 78% to 69% compared to before the methods(p=0.02). The isolation rate of MRSA was reduced by 31-42% from 2.33 to 1.35-1.60/1000 patient-days compared to before adapting strict infection control methods (p=0.04-0.07). CONCLUSION: This study showed that applying the strict infection control methods in the hospital can be effective to reduce the isolation rate of MRSA.
Anti-Bacterial Agents ; Carbapenems ; Cross Infection* ; Delivery of Health Care ; Dichlorodiphenyldichloroethane ; Glycopeptides ; Infection Control ; Korea ; Methicillin Resistance ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Seoul ; Staphylococcus aureus* ; Staphylococcus*

Statistical clinical studies of pediatric urology were made on 2,803 inpatients and 2,335 operative procedures at our department from Jan. 1957 to Dec. 1996. The statistical clinical studies of pediatric urology were summarized as follows: 1. Total number of inpatients and operations was 2,586 and 2,208 in male, 217 and 127 in female, respectively. 2. Total number of pediatric inpatients and operative procedures was markedly increased since 1980. Neonates and infants were also increased since late 1980 according to activation of antenatal clinics, especially. 3. The main diseases were cryptorchidism, hypospadias, obstruction of ureteropelvic junction (UPJO), hydrocele and urethral injury. The most common involved organ was penis and scrotum followed by urethra, kidney, ureter and bladder. 4. The main operations were orchiopexy, urethroplasty, circumcision, hydrocelectomy and pyeloplasty.
Busan* ; Circumcision, Male ; Cryptorchidism ; Female ; Humans ; Hypospadias ; Infant ; Infant, Newborn ; Inpatients* ; Kidney ; Male ; Orchiopexy ; Penis ; Scrotum ; Surgical Procedures, Operative ; Ureter ; Urethra ; Urinary Bladder ; Urology*